Focal Renal Lesions in Pediatric Patients

Son, Jennifer K.; Lee, Edward Y.; Restrepo, Ricardo; Eisenberg, Ronald L.

doi:10.2214/ajr.11.8082

Cited by 14 publications

(43 citation statements)

References 12 publications

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“…The coauthors and I appreciate the interest and comments of Dr. Sureka and colleagues [1] about our article [2], and we fully agree that, in addition to the list of major potential causes of benign lesions and anatomic variations included in our article, other benign anatomic variations, such as supernumerary fused kidneys, duplex kidney, fusion anomalies of kidneys, focal bumps or lumps in the kidneys, and congenital polar enlargement can also present as focal renal lesions in the pediatric age group [3][4][5].…”

Section: Replymentioning

confidence: 86%

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Eisenberg¹

2013

American Journal of Roentgenology

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Section: Replymentioning

confidence: 86%

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Eisenberg¹

2013

American Journal of Roentgenology

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“…Una caratteristica peculiare della WT è la sua associazione con le lesioni nefrogeniche (NR) che sono i punti focali delle cellule embrionali persistenti nel rene dopo 36 settimane di gestazione. Le NR sono presenti nei processi proliferativi pre-neoplastici associati ad un alto rischio di sviluppare il WT [1,[5][6]8,[10][11][13][14][17][18][19]. Queste lesioni precursorie sono identificate nel 30-40% dei reni che sviluppano WT unilaterale e in quasi tutti i casi di WT bilaterale; inoltre, si riscontrano in circa l'1% dei reni dei neonati al momento dell'autopsia [1,5,8,[10][11]14,[16][17]19].…”

Section: Panoramicaunclassified

“…Gli NR trovati in un rene resecato per un WT aumentano il rischio di WT nel rene controlaterale e, quindi, il paziente richiede un attento monitoraggio [19]. Anatomicamente, le NR sono suddivise in due tipi: lesioni nefrogeniche intralobari (ILNR) che sono solitamente solitarie e tendono a essere situate centralmente all'interno di ciò che rimane del rene e nelle lesioni nefrogeniche perilobari (PLNR), che sono confinate alla periferia del lobo renale e sono spesso multiple [1,[5][6]8,[10][11][13][14][16][17][18]. In genere, le NR subiscono una regressione graduale e solo l'1% di queste lesioni si trasforma in WT; inoltre, sebbene le PLNR siano più comuni delle ILNR, il rischio di trasformazione maligna è molto più elevato nelle ILNR [5,[10][11][16][17].…”

Section: Panoramicaunclassified

Current role of imaging in the management of children with Wilms tumor according to the new umbrella protocol

Varchetta

Mei²,

Tanzillo

2020

JAHC

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Wilms tumor is the most common primary renal tumor in childhood. Children with Wilms tumor typically present with an asymptomatic abdominal mass, usually detected on a routine medical checkup or discovered coincidentally by parents. The initial differential diagnosis is with extrarenal abdominal masses; once a tumor of renal origin is established, distinguishing between Wilms tumor and other primary renal neoplasms such as congenital mesoblastic nephroma, clear cell sarcoma, malignant rhabdoid tumor and renal cell carcinoma may not be easy. However, in many cases imaging findings in conjunction with the patient's clinical and epidemiological data, allow the diagnosis of Wilms tumor. Wilms tumor care offers one of the most striking examples of success of pediatric oncology. Over the last decades the European SIOP studies have been the key to developing standardized diagnostic procedures, improved risk stratification, and adjusted treatment recommendations for children with Wilms tumor and this has resulted rate of overall survival is currently greater than 90%. As in previous SIOP trials and studies, the new protocol for the diagnosis and treatment of childhood renal tumors, the UMBRELLA SIOP–RTSG 2016, mandates preoperative chemotherapy without preceding mandatory histological assessment. Therefore, imaging studies are essential to obtain a presumptive diagnosis of WT, to provide disease staging information and to measure the tumor volume after neoadjuvant chemotherapy for the purposes of postoperative treatment stratification. This review describes role of imaging in the management of children with Wilms tumor, according to the current recommendations of the UMBRELLA protocol.

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“…Normal renal structures may mimic cystic or solid neoplasm on imaging studies. On ultrasound, extensions of renal cortical tissue between the renal pyramids (hypertrophied column of Bertin) may appear as a solid mass projecting into the renal sinus ( 10 ) . Similarly, normal renal parenchyma adjacent to scarring can be misinterpreted as a solid mass.…”

Section: Errors In Interpretationmentioning

confidence: 99%

Common pitfalls in renal mass evaluation: a practical guide

et al. 2019

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More than half of patients over 50 years of age have had at least one focal renal lesion detected as an incidental finding during an ultrasound, computed tomography, or magnetic resonance imaging examination. Although the majority of such lesions can be easily detected and correctly characterized, misdiagnoses may occur and are often related to methodological limitations, inappropriate imaging protocols, or misinterpretation. This pictorial essay provides recommendations on how to recognize benign and malignant renal processes that can be potentially missed or mischaracterized in imaging studies.

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Focal Renal Lesions in Pediatric Patients

Cited by 14 publications

References 12 publications

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Current role of imaging in the management of children with Wilms tumor according to the new umbrella protocol

Common pitfalls in renal mass evaluation: a practical guide

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